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[Display omitted] Capsaicin (CAP) has been implicated as a gastroprotective agent in the treatment of peptic ulcers. However, its oral administration is hampered by its poor aqueous solubility and caustic effect at high administered doses. To address these limitations, we describe the development of gastric floating, sustained release electrospun films loaded with CAP. The nanofiber films were formulated using the polymers Eudragit RL/RS and sodium bicarbonate (SB) as the effervescent agent. The films were tested for their physicochemical properties, and film buoyancy and in vitro release of CAP were assessed in simulated gastric fluid. The cytocompatibility and anti-inflammatory properties of the films were evaluated in lipopolysaccharide (LPS)-stimulated Caco-2 cells. The amorphous films showed improved wettability, a short floating lag time (<1 s) and a total floating time of over 24 h accompanied by sustained CAP release for up to 24 h. CAP-loaded films demonstrated biocompatibility with Caco-2 cells and potential cytoprotective effects by attenuating inflammatory cytokine and reactive oxygen species (ROS) production in LPS-stimulated Caco-2 cells. The gastric floating electrospun films could serve as a platform for sustained and stomach-specific drug delivery applications. [ABSTRACT FROM AUTHOR]

Peptic ulcer disease (PUD) is one of the most common gastrointestinal disorders worldwide. Recent epidemiologic studies have suggested the protective effect of statins against the development of PUD although the results were inconsistent. This systematic review and meta-analysis was conducted with the aim to summarise all available data. A literature review was performed using MEDLINE and EMBASE database from inception to December 2017. Cohort, case-control and cross-sectional studies that compared the risk of PUD among statins users versus non-users were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. A total of 3 studies (1 case-control and 2 retrospective cohort studies) met the eligibility criteria and were included in this meta-analysis. The risk of PUD was numerically lower among statins-users compared with non-users with the pooled OR of 0.89. However, the result did not achieve statistical significance with 95% CI of 0.67–1.18. The between-study statistical heterogeneity was high (I2 = 80%). This systematic review and meta-analysis found that the risk of PUD was numerically lower among statin users. However, the results did not reach statistical significance. More studies are still required to further characterise this potential protective effect. [ABSTRACT FROM AUTHOR]

The peptic ulcer is a gastric disorder that affects millions of people and yet they cause many side effects. In this sense, natural products represent an important alternative to the discovery of compounds with gastroprotective activity. The present work has as its objective to evaluate the antioxidant and gastroprotective activity of the Hydroalcoholic Extract of Leaves from Tocoyena formosa (Cham. & Schlecht.) K. Schum (HELTF), this being much emphasized in traditional medicine for inflammatory morbidities and gastric symptoms. For the evaluation of the antioxidant activity, FRAP and DPPH tests were carried out, and for the evaluation of the gastroprotective activity, gastric lesion induction by ethanol, acidified ethanol, indomethacin and physical barrier tests were used. Antioxidant assay of HELTF revealed an EC50 of 558.66 μM FeSO4/g and IC50 of 189.78 μg/ml for FRAP and DPPH respectively. In gastroprotective, in ethanol model, all the doses presented significant activity in comparison to controls, however, in the gastric lesion induction test by acidified ethanol and indomethacin, only the dose of 200 mg/kg presented with significance. In the physical barrier test presented evidence that protection by the formation of a protective layer associated with mucus. Concluded, therefore, that HELTF possesses antioxidant and significate gastroprotective activity. [ABSTRACT FROM AUTHOR]

Nowadays, antiplatelet and anticoagulant drug medications are indicated in patients with a variety of cardiovascular disorders, such as atrial fibrillation, coronary artery disease, and peripheral artery disease. Among cardiology patients, regardless of gastrointestinal (Gl) protection, we do not infrequently encounter those patients who have signs and symptoms that are suggestive of Gl tract problems. We should bear in mind that such Gl signs and symp-toms may be attributed to Gl cancers, as well as to benign or clinically insignificant lesions. Several clinical studies have shown, albeit controversially that the predictive value of posi-tive fecal occult blood for colorectal malignant neoplasm may not be lower in patients taking antithrombotic medication. In addition, it has been shown that in patients taking antithrom-botic drug(s), diagnosed colorectal malignancies are in a relatively earlier phase, suggesting that antithrombotic drugs may facilitate the detection of otherwise unrecognized cancers. The possibility also exists that certain cardiovascular disease may be associated with a higher risk of Gl malignant neoplasms. There has been no established evidence concerning whether more aggressive Gl tract screening will reduce the probability of cancer death in cardiology patients; nevertheless, Gl tract lesions should not be overlooked among cardiology patients, especially when unexplained anemia, gastrointestinal symptoms, or positive fecal occult blood test is present, and Gl tract screening should be performed with appropriate timing. © 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. [ABSTRACT FROM AUTHOR]

Abstract: The microorganism now known as Helicobacter pylori is considered to be an important factor in the etiology of peptic ulcers. It can secrete urease enzyme and buffer gastric acids to survive in the stomach. H. pylori can colonize the gastric mucosa and preferentially adheres near the cell–cell junctions of the gastric mucous cells. In this study, pH-responsive nanoparticles were produced instantaneously upon the addition of heparin solution to a chitosan solution with magnetic stirring at room temperature. The nanoparticles appeared to have a particle size of 130–300nm, with a positive surface charge, and were stable at pH 1.2–2.5, allowing them to protect an incorporated drug from destructive gastric acids. We also demonstrated that the prepared nanoparticles can adhere to and infiltrate cell–cell junctions and interact locally with H. pylori infection sites in intercellular spaces. [Copyright &y& Elsevier]

Abstract: Objective: Cross-sectional studies have consistently reported associations between major depression (MD) and chronic medical conditions. Such studies cannot clarify whether medical conditions increase the risk for MD or vice versa. The latter possibility has received relatively little attention in the literature. In this study, we evaluate the incidence of several important chronic medical conditions in people with and without MD. Method: The data source was the Canadian National Population Health Survey (NPHS). The NPHS included the Composite International Diagnostic Interview Short Form to assess past-year major depressive episodes. The NPHS also collected self-report data about professionally diagnosed long-term medical conditions. A longitudinal cohort was interviewed every 2 years between 1994 and 2002. Proportional hazards models were used to compare the incidence of chronic conditions in respondents with and without MD and to produce age-, sex- and covariate-adjusted estimates of the hazard ratios. Results: The adjusted hazard ratios associated with MD at baseline interview were elevated for several long-term medical conditions: heart disease (1.7), arthritis (1.9), asthma (2.1), back pain (1.4), chronic bronchitis or emphysema (2.2), hypertension (1.7) and migraines (1.9). The incidences of cataracts and glaucoma, peptic ulcers and thyroid disease were not higher in respondents with MD. Conclusion: A set of conditions characterized particularly by pain, inflammation and/or autonomic reactivity has a higher incidence in people with MD. [Copyright &y& Elsevier]

Abstract Objectives: Administering proton pump inhibitors (PPI) intravenously (iv) after endoscopic treatment of bleeding peptic ulcers reduces the incidence of rebleeding, the need for operative procedures, and hospitalizations. We assessed the cost implications of iv PPI initiated in all patients presenting to the emergency department (ED) with signs of upper gastrointestinal (UGI) bleeding. Methods: From a third-party payer perspective with a time horizon of 60 days, we built a decision analytic model comparing standard endoscopic therapy to a strategy in which all patients presenting to the ED with UGI bleeding would start iv PPI before endoscopy. After endoscopy, only those with peptic ulcers would be kept on iv PPI added to standard therapy. Probabilities of health events were extracted from published literature. Resource utilization profiles and costs (iv PPI, hospital stay for medical and operative procedures, and professional fees) were based on Medicare reimbursement data from a large hospital in Alabama. All costs were expressed in 2000 US dollars. Uncertainty was investigated through one-way sensitivity analyses and probabilistic analyses using Monte Carlo simulations. Results: In a hypothetical group of 1000 individuals, routine use of iv PPI prevented 40 rebleeds, 9 surgical procedures, and 223 hospital days, and led to incremental savings of $920 per subject. Probabilistic sensitivity analyses indicated that the strategy of using iv PPI was likely to be dominant even when accounting for uncertainty. Conclusions: Based on available evidence, routine administration of iv PPI to all persons presenting with UGI bleeding represents good value for money and merits consideration as standard hospital policy. [ABSTRACT FROM AUTHOR]

Asparagus racemosus is an Ayurvedic rasayana, which finds mention in ancient Indian texts for treatment of gastric ulcers. The ulcer protective effect of methanolic extract of fresh roots of A. racemosus (ARM), 25–100 mg/kg given orally, twice daily for 5 days, was studied on different gastroduodenal ulcer models. ARM 50 mg/kg, twice daily, orally (total saponins 0.9%) showed significant protection against acute gastric ulcers induced by cold restraint stress (CRS), pyloric ligation, aspirin plus pyloric ligation, and duodenal ulcers induced by cysteamine. ARM in the above dose also significantly healed chronic gastric ulcers induced by acetic acid after 10 days treatment. However, ARM was ineffective against aspirin- and ethanol-induced gastric ulcers. Further, gastric juice and mucosal studies showed that ARM significantly increased the mucosal defensive factors like mucus secretion, cellular mucus, life span of cells and also possessed significant anti-oxidant effect, but had little or no effect on offensive factors like acid and pepsin. [Copyright &y& Elsevier]